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Get Hysa Membership Form

E Name Age Group Div. Club/Team Names (s) (USE CODE ONLY) I.D.# Region State District Last Name League Club Recreational =R Competitive =C Team First Name Init. Address City State Zip Code Area Code Telephone Number Father’s Name Month Day Birthdate Year Male = M Fem = F Occupation Coach’s License Level Player = P Coach = C Bus. Phone Optional Mother’s Name Occupation Bus. Phone Optional List any medical problem or prohibition player has Person to notify in.

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